Blue State Blues

The Abortion Battle in Seattle

As the ACLU sues American bishops for denying a Michigan woman reproductive care, Washington state is facing its own fight with Catholic hospitals over abortion coverage.

Suzanne Holland is a practicing Catholic, a professor of science and values at the Methodist-aligned University of Puget Sound, and an admirer of the commitment of Catholic hospitals to serve the poor, regardless of cost. But she’s also a lesbian, and despite her religious affiliation, she’s wary of going to her local Catholic hospital for her own healthcare needs.

“I would prefer not to use the Catholic hospitals in my area because I don't know if they would recognize my domestic partner,” Holland said recently. “We’re not legally married, so I don't know if they’d recognize her as my healthcare surrogate or not.”

Holland’s dilemma has been playing out all across Washington State for the past few years as more and more of the state’s hospital beds come under the control of the Catholic Church. According to one estimate, ten mergers between Catholic and non-Catholic hospitals have been proposed or completed in the past three years—and affiliations with Catholic hospitals come with significant strings attached for their secular partners.

In one high-profile case, when Seattle’s Swedish Health Services partnered with the Catholic giant Providence Health Services last year, both companies avowed that Swedish Health would stay secular. Yet soon afterwards, Swedish Health announced that it would stop providing elective abortions, and instead give $2 million to Planned Parenthood to open a clinic nearby that would provide a full range of reproductive services.

Also on the chopping block at many newly-merged Catholic and non-Catholic hospitals are services like tubal ligations, a surgical birth control method often performed after C-section, and physician-assisted suicide, which Washington legalized under its Death with Dignity Act in 2008—one of only two states to do so, along with Oregon. Activists also worry that LGBT patients and their families, like Holland and her partner, will be denied visiting rights and equal treatment at newly Catholic-controlled hospitals.

“What we have heard from the private Catholic systems is that they are going to be respectful of LGBT people, and we actually don’t doubt that,” said Kathy Reim, an activist for LGBT rights who started the group People for Healthcare Freedom to protest proposed mergers in her Washington hometown. “But here’s the question for us—it’s different if a person goes in with a broken arm. We know they’ll be treated with respect. The question we have is, how are they going to treat someone who goes in specifically for a procedure that’s related to being LGBT?” In vitro fertilization for lesbian couples, hormone treatments, and gender transition surgery could all fall into this category, says Reim.

Reim’s home county of Skagit, in northern Washington, is at the latest epicenter of the brewing conflict—three local hospitals made moves this year to partner with PeaceHealth, a Catholic health system that’s active throughout the state. Of the three, two are currently hashing out the details of their arrangements with PeaceHealth, while the third decided not to go through with the process. Still up in the air is the question of whether the local hospitals will conform to PeaceHealth’s “Statement of Common Values,” which echoes Catholic doctrine.

Washington isn’t alone in facing hospital mergers that could threaten reproductive rights and care for LGBT families—cities in Pennsylvania, California, and Connecticut have all seen similar cases. But nowhere else have so many mergers taken place in such a short time span, leading some to speculate about why the reliably blue Washington state finds itself in the hot seat.

“We don't know exactly why this is,” Leah Rutman, a policy counsel to the American Civil Liberties Union of Washington, told The Daily Beast. “One of the theories is that [it’s] because Washington State tends to be a very progressive, liberal state, which has passed Death with Dignity, the Reproductive Privacy Act, the fundamental right to abortion and birth control. This is sort of the way Catholic hospitals can—in some other states they can probably make these things happen more through laws or regulations and here that hasn’t been as possible.”

Whatever the cause, state officials are taking note. Governor Jay Inslee, a Democrat, issued a directive over the summer instructing the Department of Health to strengthen its regulation process for hospital partnerships—which will translate into more oversight for the upcoming Skagit County mergers. And the state’s Attorney General, Robert Ferguson, issued a legal opinion around the same time in which he said that hospital districts that receive tax funding and provide maternity care must provide equal services or information on contraceptives and abortion. It’s unclear yet exactly how Ferguson’s opinion will affect Catholic organizations, but activists say it’s a step in the right direction.

Meanwhile, hospital officials at both ends of the upcoming partnerships deny that mergers between Catholic and non-Catholic institutions will affect access to reproductive health care and other procedures that go against Catholic teachings.

“There are only two services that PeaceHealth will not provide: the first is elective abortion, and the second is physician-assisted suicide,” says Tim Strickland, a PeaceHealth representative. “Those procedures are rarely if ever performed in hospitals anyway. And I can tell you that in the case of both Skagit Valley and Cascade Valley”—the two hospitals in talks with PeaceHealth—“before we were ever invited into those communities, those organizations did not perform physician-assisted suicide nor did those hospitals perform elective abortions.”

A representative for Cascade Valley Hospital confirmed this, but said it wasn’t an institutional decision but an individual one—no physicians at the hospital had requested privileges to perform abortions. The ACLU of Washington, though, said this was still a concern.

“Just because a hospital doesn't currently provide a service, doesn't mean that potential of that service not being provided in the future shouldn't be taken into account,” says Rutman. “So if a hospital doesn't provide a service now, but in ten years, no one else in the area is providing it and so it’s important someone provides it, but they can’t because they’ve now merged, that’s still a problem for us.”